To correct deficiencies in traditional medical school and post-graduate physician training related to disparities in health conditions that burden minority populations, this project has 3 long-term objectives [1-Develop novel cultural competence education (CCE); 2-Provide learners with patient-based CC experiences; 3-Disseminate CC evidence-based health care best practices] that will be achieved through 6 specific aims [1-Develop comprehensive, integrated cultural CCE for medical students; 2-Measure baseline CC prior to implementing CCE; 3-lmplement CCE in a medical school cohort; 4-lmplement post-graduate medical CCE; 5-Measure changes in CC resulting from CCE; and 6-Develop a CC best practices toolkit for medical educators and practitioners using a variety of advanced technology formats]. Building upon the University of Rochester's role as an innovator in medical education (as the home of the established "biopsychosocial" model of patient care and a newer "double-helix" curriculum in which basic science and clinical coursework are intertwined throughout the 4-year medical school curriculum), this 5-year project is planned in two sequential phases (curriculum development 0-24 months and implementation 25-60 months), with some overlap likely. At the medical student level, innovations in CCE will include lectures, discussions, case presentations, simulated patients and exercises, and cultural immersion in all 4 years of basic science and clinical activities. At the post-graduate level, experiential exercises and case-based learning will occur. For continuing professional education, annual departmental Grand Rounds pertaining to issues of cultural competence will be incorporated. Rigorous evaluation will focus on learning objective achievement, as well as process measures. Dissemination of the curriculum and educational tools will be facilitated by programs in professional societies, providing an easily accessible website with a teacher's handbook relative to the simulated patient cases, and creating an interactive CD-ROM and other resources determined by needs assessment of the audience.